Part B News Features
Question: The physician is performing a pleural catheter flush using saline with manual clearance of clots under ultrasound in the outpatient setting. Should we bill an E/M code (99212-99215) depend... More
Question: A new patient came in and saw our physician assistant (PA) for some lacerations. She did not see a doctor. A week later the patient returned for follow up with an M.D. For purposes of billin... More
While sleep studies and continuous positive airway pressure (CPAP) devices are getting more popular, Medicare billing for them so far has held pretty steady. But as the tough denial rates for a major ... More
Question: The physician is performing a pleural catheter flush using saline with manual clearance of clots under ultrasound in the outpatient setting. Should we bill an E/M code (99212-99215) depend... More
Question: A new patient came in and saw our physician assistant (PA) for some lacerations. She did not see a doctor. A week later the patient returned for follow up with an M.D. For purposes of billin... More
While sleep studies and continuous positive airway pressure (CPAP) devices are getting more popular, Medicare billing for them so far has held pretty steady. But as the tough denial rates for a major ... More
Tools
Modifier 25 indicates a "significant, separately identifiable E/M service." Incorporate the tips below and click the "Download file" link above to access a modifier 25 decision tree.
This major final rule aligns the E/M coding and payment with changes recommended by the CPT Editorial Panel and AMA RUC for office/outpatient E/M visits. The final rule also adds services to the telehealth list and updates payment policies, payment rates and other provisions for services furnished under the Medicare physician fee schedule on or after Jan. 1, 2020.

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